MicroRNAs from the miR-371~373 and miR-302/367 clusters, particularly miR-371a-3p, are promising biomarkers for blood-based diagnosis and disease monitoring of malignant germ cell tumors (GCTs) and are nearing clinical implementation. These biomarkers have superior sensitivity and specificity compared with current markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). We explored patient acceptability of using circulating microRNAs to replace multiple serial computed tomography (CT) scans in malignant GCT follow-up.
Two workshops involved interactive presentations and focus groups. Discussions were digitally recorded and transcribed verbatim. Qualitative thematic analysis of transcripts identified the key themes.
Prior to the workshops, potential participants expressed concern about the adoption of new blood tests due to personal experiences of the limitations of existing (AFP/HCG) markers. Twelve males (22-57 years of age; currently, 26-59 years of age) with a malignant GCT diagnosis participated; all were in follow-up. Three had experienced recurrence. Participants had cumulative exposure of between 1 and 15 CT scans. Data saturation was reached at the second workshop; five themes emerged underpinning preference for microRNA testing versus CT scans: (1) increased sensitivity and safety, (2) reduced financial costs, (3) reduced time for testing and results, (4) practicalities, and (5) reduced anxiety. However, some participants perceived an increased diagnostic capacity of CT scans versus blood testing.
This first user consultation of circulating microRNA testing for future malignant GCT follow-up suggests high acceptability with potential patient and healthcare system benefits.
Clinical genitourinary cancer. 2021 Mar 17 [Epub ahead of print]
Lorna A Fern, Michelle Greenwood, Shievon Smith, Susan Brand, Nicholas Coleman, Daniel P Stark, Matthew J Murray
Oncology Division, University College London Hospitals NHS Foundation Trust, London, UK; National Cancer Research Institute Teenage and Young Adult and Germ Cell Research Group, London, UK. Electronic address: ., Department of Medical Oncology, St Bartholomew's Hospital, London, UK., It's in the Bag Charity, Bristol Haematology and Oncology Centre, Bristol, UK., Department of Pathology, University of Cambridge, Cambridge, UK., National Cancer Research Institute Teenage and Young Adult and Germ Cell Research Group, London, UK; Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK., National Cancer Research Institute Teenage and Young Adult and Germ Cell Research Group, London, UK; Department of Pathology, University of Cambridge, Cambridge, UK; Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.